Duplex ultrasound analysis of hemodynamic changes following microsurgical repair of unilateral digital artery injuries: a retrospective follow-up study.

Microsurgically repaired unilateral digital arteries demonstrated high long-term patency rates at a mean follow-up of 37 months.

• 26 of 27 reconstructed arteries (96.3%) demonstrated anterograde flow on duplex ultrasonography.
• Mean follow-up was 37 months with a range of 16-82 months.
• The study included 27 patients who underwent primary microsurgical anastomosis between 2017 and 2022.
• Patients with fractures, proximal injuries, or vein grafts were excluded from the analysis.

Flow volume in repaired digital arteries was significantly lower than in the contralateral artery of the same digit.

• Median flow volume in the repaired artery was 1.1 ml/min (IQR: 0.5-2.8).
• Median flow volume in the contralateral artery of the same digit was 3.6 ml/min (IQR: 1.4-7.7).
• The difference between repaired and contralateral same-digit arteries was statistically significant.
• Flow volume in the repaired artery was also lower than the corresponding artery of the contralateral hand (2.8 ml/min, IQR: 1.3-6.8).

No significant compensatory increase in flow was observed in the intact artery of the injured digit compared to its contralateral counterpart.

• The intact (uninjured) artery of the injured digit did not show a statistically significant compensatory flow increase.
• This finding was demonstrated by comparison with the corresponding artery of the contralateral hand.
• The absence of compensatory hyperflow suggests the repaired artery contributes to overall digit perfusion rather than being functionally redundant.

Duplex ultrasonography was used as the primary assessment tool to evaluate patency and flow characteristics of repaired digital arteries.

• The study was a retrospective single-center design.
• Duplex ultrasonography assessed both arterial patency and blood flow volume at follow-up.
• Injuries were limited to the level of the digit with primary microsurgical anastomosis.
• Patients with fractures, proximal injuries, or vein grafts were excluded to reduce confounding variables.

Whether unilateral digital artery injuries benefit from surgical repair remains controversial given preserved perfusion from the contralateral artery.

• Evidence on long-term patency and hemodynamic effects of reconstructed unilateral arteries is described as limited.
• Perfusion is typically preserved by the remaining, contralateral artery in unilateral injuries.
• The functional benefit of arterial repair was described as 'uncertain' by the authors.
• Long-term patency was suggested to support a potential role for repair in selected cases to maintain vascular integrity.